Helping elders unable to help themselves

Those professionals are dealing not just with cases of mistreatment but also self-neglect.

Sometimes the most complex ideas have humble beginnings—a late-night epiphany or an inspired note written on the back of a hand. Sometimes they even occur in a pizza joint.

“Like a lot of ideas, it starts on a napkin,” says Tom Price, chief of medicine at Emory’s Wesley Woods Hospital, remembering the drafting of a plan to help prevent elder abuse and neglect in DeKalb County, Ga.

After mapping out logistics with colleagues, Price went on to negotiate a working relationship between Emory Healthcare, Wesley Woods, and DeKalb County to implement the idea. The joint effort resulted in Vulnerable Adults Living At Risk Invisibly (VALARI), a multidisciplinary team that prosecutes cases of neglect and provides support to victims who need medical attention or, in some cases, shelter.

TAME, or the Taskforce Against the Mistreatment of Elders, is a program within the Emory Center for Health in Aging that grew up alongside VALARI. TAME’s goal is to help educate professionals—specifically social workers, law enforcement, and health care providers—about what to do when they find instances of abuse.

The idea had outgrown the napkin.

Elder abuse is a difficult crime to combat, requiring cooperation among different professions. It exists in many forms, ranging from physical and sexual to mental and financial. Those professionals are dealing not just with cases of mistreatment but also self-neglect.

For victims of elder abuse, “we explain the system and go to court with them,” says Betsy Ramsey, who works in DeKalb County’s special victims unit and VALARI.

However, cases often are able to be resolved without prosecution. The bigger burden for health care professionals, says Price, is to report suspicion, with nurses and doctors evaluating each patient’s medical history to establish whether ailments stem from abuse or another cause.

Once victims are identified, VALARI’s safety action plan kicks in. Based on needs and desires, the abused person will receive help moving to an apartment at Wesley Woods Center or the home of a trustworthy friend or relative and be given any needed medical attention.

Price recalls one case where an elderly woman, being cared for by her son, was found in an unkempt home with waste matter on and around her. On investigation, the VALARI team found that the caretaker was neglecting his own medical condition, which had led to the unacceptable living conditions for both mother and son. As a result, both were given assistance.

These cases of abuse are not merely about catching a criminal. They are about helping those unable to help themselves, says Ramsey. —Stone Irvin